Tretinoin Topical
Indications
Tretinoin Topical is used for:
Acne, Mottled hyperpigmentation, Roughness and fine wrinkling of photodamaged skin
Adult Dose
Topical/Cutaneous
Acne vulgaris
Adult: Apply once, usually at bedtime, onto affected area which has been previously cleansed to remove excessive oiliness and dried.
Therapeutic response may be seen after 6-8 wk.
Mottled hyperpigmentation, roughness and fine wrinkling of photodamaged skin
Adult: Apply a pea-sized amount onto entire face once daily at night.
Therapeutic response may be seen after 6 mth.
Child Dose
Topical/Cutaneous
Acne Vulgaris
<12 years: Safety and efficacy not established
>12 years: Apply once, usually at bedtime, onto affected area
Renal Dose
Administration
Contra Indications
Hypersensitivity to retinoids. Application to eczematous, sunburnt or abraded skin. Pregnancy, lactation.
Precautions
Avoid concomitant topical applications, esp keratolytic agents. Avoid exposure to sunlight, UV light and weather extremes (e.g. cold). Keep away from eyes, mouth, angles of nose, mucous membranes or open wounds. In case of severe local erythema, oedema, blistering or crusting, use less frequently or discontinue. Avoid medicated or drying soaps, abrasive soaps and cleansers, frequent washing and harsh scrubbing. Avoid use of topical preparations with high concentrations of alcohol, menthol, spices or lime.
Pregnancy-Lactation
Pregnancy category: C
Lactation: Not known whether excreted in breast milk
Interactions
Enhances percutaneous absorption of minoxidil. Increased risk of fatal thrombotic complications with antifibrinolytic. Increased tretinoin concentrations with azole antifungals. Enhances peeling action of sulphur, resorcinol, benzoyl peroxide, salicylic acid. Increased photosensitivity with photosensitising medications eg, thiazides, tetracyclines, fluoroquinolones, phenothiazines and sulfonamides.
Potentially Fatal: Increased risk of intracranial pressure with tetracyclines.
Adverse Effects
Side effects of Tretinoin Topical :
Initial exacerbation of symptoms, skin irritation, stinging on application, oedema, blistering, crusting of the skin, erythema, scaling, photosensitivity, temporary hypo/hyperpigmentation.
Mechanism of Action
Tretinoin is a trans-retinoic acid form of vitimin A. It stimulates mitosis and turnover of follicular epithelial cells and reduce their cohesiveness. This facilitates extrusion of existing comedones and prevents formation of new comedone. It also exhibits thinning effect on the stratum corneum. In acute promyelocytic leukaemia, it induces cellular differentiation and decreases proliferations.